Spine
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A new stimulus-triggered electromyography (EMG) test for detecting stimulus diffusion to contralateral intercostal muscles during thoracic pedicle screw placement was assessed in a porcine model. ⋯ Stimulus-triggered EMG can identify screws that violate the medial pedicle wall if they are in contact with neural tissues. EMG thresholds could not discriminate screws that violated the medial pedicle wall without neural contact from screws with accurate intraosseous placement. However, recording EMG potentials at the contralateral intercostal muscles (stimulus diffusion phenomenon) proved to be a reliable method for identifying the neural structures at risk.
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Randomized Controlled Trial Comparative Study
A prospective randomized study of clinical outcomes in patients with cervical compressive myelopathy treated with open-door or French-door laminoplasty.
A prospective randomized clinical study. ⋯ Perioperative complications occurred more frequently in open-door laminoplasty than in French-door laminoplasty. JOA scores and recovery rates suggested that both open-door and French-door laminoplasties could be similarly effective in decompressing the spinal cord. Axial pain was improved in French-door laminoplasty but became worse in open-door laminoplasty. SF-36 suggested that French-door laminoplasty could be more beneficial than open-door laminoplasty for patients with cervical compressive myelopathy.
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Retrospective outcome measurement study. ⋯ No evidence was found for OPLL to have any effect on the initial neurologic status or recovery in motor function after traumatic cervical cord injury, suggesting that the neurologic outcome is not significantly dependent on canal space.
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Prospective study with 12-month follow-up. ⋯ Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations.
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A 2-year follow-up in a birth cohort of adolescents aged 15 to 19 years. ⋯ As very few adolescents did not report any pain, the relevance of self-reported pain is questionable without assessment of pain-related disability. The clinical relevance of these pain combinations must be evaluated in further studies.